Med Student "Scut" Texting

[WinslowPringle]

Question: After my med students have wandered off after I've told them I will be doing x,y,z menial tasks (e.g., pulling drains, wound vac changes, etc) in 20 minutes and they ask me to text them before I do it so they can come "help," should I: text them before I do it, tell them to stick with me in between and they can watch me chart and then we'll do the tasks together, or let them wander off and not contact them before I go do some scut?

Context: Went to a Big Academic Center for Med school; residents and Med students all hung out between surgeries/rounds in the same room. If there was something to do, the entire team did it together. So no question then of what the residents were up to. Now I'm at a community program with tons of autonomy. Most rotations, I operate all day, so the med students are with me and we go hit scut between cases. Now I'm on a critical care-heavy and less operative intensive rotation, so there isn't that continuity. The med students have their own study room, and the residents have their own call/study rooms. After quick rounds, the students wander off (not talking about my formally dismissing them and telling them to go study, they just wander away) because I usually have some charting and order entering to do in the unit, nothing glamorous but stuff that has to be done and no doc box area, so no good place for the students to sit. During rounds I have mentioned that I have to go do some dressing changes/ re-round on patients/do a bronch/EGD/biopsy/ or have a family meeting after I finish orders+charts+nurse swarm control. The med students ask me to text them before I go do it, so they can come; then they go back to wherever they are hiding. So, do I say, sure, let me add one more step into my already busy 100hr plus week so I can spoon feed you? Or do I say no, just stick with me and stand there breathing over my shoulder while I chart and we'll go later? Or just blow it off and let them go do whatever it is they are doing?

I don't mind texting if I've formally said "Ok, nothing educational here, go 'study'." and then a consult or new admit or something interesting comes in. It just irks me to have to practically invite them to watch me do scut. Even after I've text-invited them to stuff, they have missed out on family meetings, bedside procedures, etc. And I can't scut them out - it takes longer and I can't trust them enough to go get the supplies let alone start stuff without me. What's going on here? I'm starting to feel that "Show me a medical student who only triples my work, and I will kiss his feet," is pretty true.

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[el_duderino]

I dunno man, what you refer to as scut sounds like valuable educational opportunities for students. I never felt like I got enough of that stuff.

Just have a group text open in your texting app, and say "Room a210 in 2 minutes" or whatever.

Part of your job is teaching. It's not extra work on top of your other work.

 

[WinslowPringle]

I dunno man, what you refer to as scut sounds like valuable educational opportunities for students. I never felt like I got enough of that stuff.

Just have a group text open in your texting app, and say "Room a210 in 2 minutes" or whatever.

Part of your job is teaching. It's not extra work on top of your other work.

It's not the teaching, it's the students disappearing and my having to invite them back to be taught that irks me.

 

[el_duderino]

It's not the teaching, it's the students disappearing and my having to invite them back to be taught that irks me.

Well you made it clear that the alternative to them "disappearing" is having them literally stand over your shoulder in the resident room, making you uncomfortable while you put in orders and write notes.

If that's what you want them to do, you should probably tell them that. You're not going to get the message across to them by letting them sit down somewhere while you silently seethe and feel bitter.

 

[WinslowPringle]

Well you made it clear that the alternative to them "disappearing" is having them literally stand over your shoulder in the resident room, making you uncomfortable while you put in orders and write notes.

If that's what you want them to do, you should probably tell them that. You're not going to get the message across to them by letting them sit down somewhere while you silently seethe and feel bitter.

It's in the ICU or floor area, all open concept, not a resident room. And unfortunately, there isn't a good place for them to sit or stand; but they don't make me feel uncomfortable. I think it would be beneficial for them to stick around. I'm more mildly annoyed than bitterly seething.

Are you in a place where everyone is all together most of the time or do students have an expectation of being separated and called back if there is some learning opportunity? It was just super different for
med school for me and previous rotations in residency w/ students.

 

[darknecrosforte]

From the student perspective, I'd think it would be better to just follow you and learn how to not get in the way (and other "soft skills"). Asking a busy person for the opportunity to possibly annoy them (and feed into the "weak, entitled Millenials" stereotype) is strange.

I expect to use/develop my situation-awareness and stealth when I start rotations this summer. I can totally see some of my younger classmates hoping to get texts on rotations though...

 

[PlutoBoy]

You go from writing notes to wound care to performing EGDs and bronchs?!

 

[rokshana]

It's in the ICU or floor area, all open concept, not a resident room. And unfortunately, there isn't a good place for them to sit or stand; but they don't make me feel uncomfortable. I think it would be beneficial for them to stick around. I'm more mildly annoyed than bitterly seething.

Are you in a place where everyone is all together most of the time or do students have an expectation of being separated and called back if there is some learning opportunity? It was just super different for
med school for me and previous rotations in residency w/ students.

so if there is no place for them to BE in the icu and they have a study area that they go to, then what do you expect them to do if you are not interacting with them?

You sound like you want your cake and eat it too...you want to be left alone to do the "scut" work you need to do and feel having the students hang around you is a bother...but somehow you want them to miraculously figure out exactly when you plan to finish the "scut" and show up when there are real things they need to see. YOU need to decide how you are going to deal with your med students and let them know what your expectations are of them as med students...they can't read your mind. If you want them to be available at a moment's notice, then they need to be with you at all times...sometimes that may not seem educational to you, but remember, they are students...new clinical students...all those things you see as "scut" are new to them...

The fact that they are asking you to text them when you are going to do something you deem educational sounds like they want to be involved...just have a group text that you send out that says " meet me at so and so at whatever time". IF they don't show up, well that's a different story...especially if you have made a point of saying that when i text you, you need to show up.

If you can't '"trust" them to do stuff, well then you haven't taught them appropriately...that onus is on you as the intern/resident.

If you are not teaching them something or paying attention to them, or giving them something to do, they are going to disengage...and be careful, because that can show up on your evaluations...

 

[toastee]

Why not just tell them "Go study XXX topic and I'll shoot you a text when we're ready to roll." Then tell them to meet you wherever in 5 minutes. After the fact, you can have them give you a short presentation on the topic you asked them to read about. This way, they're out of your hair and you know they're reading/learning. I'd rather my intern/resident give me a topic to read/talk about than have them feel like they just want me to stand around next to them at all times and get mad when I decide to sit down in my designated studying area.

 

[Winged Scapula]

Setting expectations is always key. I always do it the first day of a rotation and I am clear that I hate "not being able to find you". Maybe some just figure, "its their education" but I find it insulting because teaching is more work for me and I've agreed to do it so I expect them to respect that.

However, I don't want someone hovering over me when I'm doing something they really can't help with: dictation for example.

So as others have noted, you say to them, "go grab something to eat/read up about <management of X> and meet me in room Y in 30 minutes". There are sometimes small things you can assign them, "Hey Joe, go and make sure there is a suture removal kit and some dressings supplies in Mrs. Johnson's room. Let her know we'll be there to do it in 30 minutes so she's in her room ready." "Susan, call RT at this number and let them know Mr. Smith in Room 2045 is doing great and I want them to come by and see if he's ready for extubation", whatever.

 

[el_duderino]

It's in the ICU or floor area, all open concept, not a resident room. And unfortunately, there isn't a good place for them to sit or stand; but they don't make me feel uncomfortable. I think it would be beneficial for them to stick around. I'm more mildly annoyed than bitterly seething.

Are you in a place where everyone is all together most of the time or do students have an expectation of being separated and called back if there is some learning opportunity? It was just super different for
med school for me and previous rotations in residency w/ students.

If expectations are unclear, I ask the resident what they want me to do. If they're not doing what you want, tell them what you want them to do!

 

[Psai]

I understand that it's annoying to have medical students disappear but they need to study for their shelves, step 1 or 2, look up things for tomorrow's operation etc. Surgery hours are long for medical students. I would let them study and then tell them to meet you at room 5 in 10 minutes. As a student I always carried around the wound bucket so I would have all my supplies at the ready. Teach them to put in an ng or change a dressing and eventually they will be able to handle it alone and you will save some time as you check it later. Even if it doesn't pay dividends right away, it will make them a better and more useful sub-i and intern later on.

I agree with everyone about setting expectations. Medical students are just trying to get through the day without getting yelled at. Being useful is the cherry on top.

 

[Winged Scapula]

I always just assumed that "text me if anything interesting comes up" was this generations equivalent of asking "is there anything else I can help you with?" - i.e. A code word for "peace, I'm out."

well that explains why a lot of people then don't call or text the medical student. I've heard students complain about that and I guess I never thought that it would be interpreted that way although it makes perfect sense.

 

[Winged Scapula]

I mean even if they want to be texted, I'm not super thrilled about that plan.

In the middle of my twenty tasks I'm supposed to text the student to show up for the fun ones only? "Ding, its education time, please come now"

It's (a) kind of insulting and (b) I'm almost certain to forget if I'm really busy

yes I understand the "too busy" aspect of it which is what I assumed the issue was for the residents.

The issue of protecting students or students wanting to be protected from the more mundane things is a real one. I know everyone wants to move from cracking a chest in the trauma bay to extubating the long term vented patient who miraculously comes back to life surrounded by their appreciative crying family to taking out a pristine robins egg blue gallbladder in20 minutes to reattaching fingers on a piano player's dominant hand.

But life is not full of such sexy and fun stuff and as you say, it's insulting to the patients that we care for who might need something as boring as prescriptions written or a discharge summary done and it's insulting to your time that we're expected to only involve the students when we're doing something cool.

For me it's all about how interested the students are. Fortunately I'm lucky because my rotation is an elective but sometimes I get those end-of-the-year fourth-year student who would rather be anywhere else, especially those not going into surgery, and I have to admit I'm much less likely to call them when something interesting is going on if they're not right there. The ones who show a little enthusiasm and initiative are more likely to get a phone call.

 

[jdh71]

I don't text my residents or students. I don't expect them to be at my hip, but I tell them if they are not immediately available in the ICU when I try to find them, I'm not going to try hard to track them down. And there is a workstation area when they can wait. I'll walk a 3rd or 4th year student through a central line, but I won't run them down.

Do I go down the "entitled and spoiled" generation route here? Shake my fist and threaten to call the cops if they don't get off my lawn? I think students are worse now, generally speaking. This texting stuff is just confirmation bias I guess for my post hoc rationalizations. Wump wump.

 

[ThoracicGuy]

You go from writing notes to wound care to performing EGDs and bronchs?!

There is life beyond charting!

 

[jdh71]

There is life beyond charting!

Lies.

 

[el_duderino]

I don't text my residents or students. I don't expect them to be at my hip, but I tell them if they are not immediately available in the ICU when I try to find them, I'm not going to try hard to track them down. And there is a workstation area when they can wait. I'll walk a 3rd or 4th year student through a central line, but I won't run them down.

Do I go down the "entitled and spoiled" generation route here? Shake my fist and threaten to call the cops if they don't get off my lawn? I think students are worse now, generally speaking. This texting stuff is just confirmation bias I guess for my post hoc rationalizations. Wump wump.

That's fine. It's better than saying you'll text then just being annoyed and angry that they're not always there watching you.

Whatever your expectations are, set them and give the students a chance to meet them. Don't make them try to guess what the expectations are and complain online that they don't know.

 

[DokterMom]

How many do you have at a time? Can you have one designated as 'shadow', and one as 'fetch' ? Use the 'fetch' for minor errands and the 'shadow' to call the others? Switch roles so everyone gets a turn

 

[Football Pig]

Question: After my med students have wandered off after I've told them I will be doing x,y,z menial tasks (e.g., pulling drains, wound vac changes, etc) in 20 minutes and they ask me to text them before I do it so they can come "help," should I: text them before I do it, tell them to stick with me in between and they can watch me chart and then we'll do the tasks together, or let them wander off and not contact them before I go do some scut?

Context: Went to a Big Academic Center for Med school; residents and Med students all hung out between surgeries/rounds in the same room. If there was something to do, the entire team did it together. So no question then of what the residents were up to. Now I'm at a community program with tons of autonomy. Most rotations, I operate all day, so the med students are with me and we go hit scut between cases. Now I'm on a critical care-heavy and less operative intensive rotation, so there isn't that continuity. The med students have their own study room, and the residents have their own call/study rooms. After quick rounds, the students wander off (not talking about my formally dismissing them and telling them to go study, they just wander away) because I usually have some charting and order entering to do in the unit, nothing glamorous but stuff that has to be done and no doc box area, so no good place for the students to sit. During rounds I have mentioned that I have to go do some dressing changes/ re-round on patients/do a bronch/EGD/biopsy/ or have a family meeting after I finish orders+charts+nurse swarm control. The med students ask me to text them before I go do it, so they can come; then they go back to wherever they are hiding. So, do I say, sure, let me add one more step into my already busy 100hr plus week so I can spoon feed you? Or do I say no, just stick with me and stand there breathing over my shoulder while I chart and we'll go later? Or just blow it off and let them go do whatever it is they are doing?

I don't mind texting if I've formally said "Ok, nothing educational here, go 'study'." and then a consult or new admit or something interesting comes in. It just irks me to have to practically invite them to watch me do scut. Even after I've text-invited them to stuff, they have missed out on family meetings, bedside procedures, etc. And I can't scut them out - it takes longer and I can't trust them enough to go get the supplies let alone start stuff without me. What's going on here? I'm starting to feel that "Show me a medical student who only triples my work, and I will kiss his feet," is pretty true.

As a student on the other side of the fence, I can see your perspective. The problem is that you need to have procedures or a system in place so that students know what to do. Otherwise, don't expect them to just magically know when and where to be somewhere. If you don't like them watching you chart or other similar tasks, then you need to tell them somewhere to be and you can go grab or text them when you're ready. Otherwise, how are students supposed to know?

 

[Football Pig]

That's fine. It's better than saying you'll text then just being annoyed and angry that they're not always there watching you.

Whatever your expectations are, set them and give the students a chance to meet them. Don't make them try to guess what the expectations are and complain online that they don't know.

Perfect post x1,000,000

 

[rokshana]

There is life beyond charting!

no there isn't...

 

[NotAProgDirector]

Tell them to set up for the scut activity (which they probably see as super valuable, rather than scut), and then study there while waiting for you

 

[TraumaLlamaMD]

I remember as a student, when my residents were charting and dictating, I used to do things like "urine rounds" where I'd go check up on patients and track down the I/Os that never made it into the computer. I figured out where the supply rooms were and had a list of items needed for common floor tasks (NG tube, drain removal, etc) and would get that stuff assembled if we'd talked about doing a task on rounds. I'd check in every once in a while to see how the residents were doing and if it was time to go get stuff done. I never felt like it was scut work, I felt like it was helping the team - and in retrospect it was, because calling 8 nurses to get UOP on 14 patients is a huge pain when you're answering pages and trying to finish notes.

Tl;dr: find small tasks for them to do that will actually be helpful to the team, which they can take care of while you're busy. They'll be nearby on the floor accomplishing tasks, not hidden in their cubby, and they'll know when procedures are going to happen because they helped you prepare.

 

[WinslowPringle]

You go from writing notes to wound care to performing EGDs and bronchs?!

Yep. Surgery can be fun....that day I also did two OR cases, a line, and some consults.

...what do you expect them to do if you are not interacting with them?

I don't think med student education should be entirely dependent on my constant interaction with them 100% of the time. I expect them to listen to a general conversation about patient care with the nurses on the ICU patients they're following, even if I am not talking to the med student directly.

you want to be left alone to do the "scut" work you need to do and feel having the students hang around you is a bother...but somehow you want them to miraculously figure out exactly when you plan to finish the "scut" and show up when there are real things they need to see.

I don't care if med students are there or not; if they are, I'll teach and if not I won't. I had clearly announced I would be doing certain tasks in certain rooms at a certain time. It shouldn't take a miracle for them to figure out where and when they should be there.

they can't read your mind. If you want them to be available at a moment's notice, then they need to be with you at all times...sometimes that may not seem educational to you, but remember, they are students...new clinical students...

These are some M4s, not exactly brand new. As mentioned, I had announced what, where, and when - no mind reading required. Had they stuck around, they would have been ready. Or they could have left and come back on time without a problem. Instead, they left for the boring parts, but wanted me to invite them back for the fun stuff. I happen to think the notes/nurse interactions/etc. is educational for them; they apparently didn't.

If you can't '"trust" them to do stuff, well then you haven't taught them appropriately...that onus is on you as the intern/resident.

These are M4s. They were on the rotation before I started, and I've worked with them for a total of 8 days. And we're talking about their ability to locate dressing supplies and start to take off an ABD and gauze, not perform an ex-lap.

If you are not teaching them something or paying attention to them, or giving them something to do, they are going to disengage...and be careful, because that can show up on your evaluations...

That sounds infantalizing to med students. If a resident is not constantly teaching them or constantly paying attention to their precious selves, they have no choice but to disengage? I think adults should be able to go 20 minutes while listening to a general conversation about patient care without my having to directly spoon feed them. Or what, they'll revenge eval me? Hasn't happened yet, my evals are fine.

Why not just tell them "Go study XXX topic and I'll shoot you a text when we're ready to roll."

If there is nothing going on, I do dismiss them to home or study or wherever. But there were things going on, and they just left (which is fine) but then asked me to invite them back.

I understand that it's annoying to have medical students disappear

No, it's not annoying to have med students disappear. If they're present, fine; if not, they're paying a lot of money for whatever it is they're doing.

Surgery hours are long for medical students.

Surgery hours are longer for surgery residents.
These med students lead a cush surgery life - never in before 0530 and usually in at 0630, never home later than 1730. Today I sent them home at 2pm. On the day ERAS 'opened', I sent them home at 10am. They have had at least a 30minute sit-down lunch every day and have had at least one hour every day during the work day to themselves.

As a student I always carried around the wound bucket so I would have all my supplies at the ready.

Stud.

Teach them to put in an ng or change a dressing....

Well, I'm trying....
I don't care if they're actually useful. Like 'Shem' says, if they'll only triple my work, I'll kiss their feet.

How many do you have at a time? Can you have one designated as 'shadow', and one as 'fetch' ? Use the 'fetch' for minor errands and the 'shadow' to call the others? Switch roles so everyone gets a turn

1-4. I like the shadow idea; have used it a few times. In this particular case, though, they all skeedaddled.

To clarify: Team rounds finishing up, I announce I am going to do xyz in rooms a,b,c in about 20 minutes. Formal rounds end (the attending leaves), med student says 'Will you text us before you start?'. I'm a bit nonplussed because there is still a group of people around, med students mixed in, and I've already said when I'll start. It's open concept area, I'm at a computer and going to discuss patient care with the nurses while referencing the EMR/doing orders/updating notes (surgery notes, not the medicine novel ones); these are patients the students are following and it's a general conversation. I look around, and then the med students are gone. Hadn't had a chance to formally dismiss them (which I wasn't going to do immediately, since there were procedures and things to do still and I thought the convo useful to them); hadn't had a chance to review their notes individually with them - which I had done on previous days. It was just not a juncture at which I would expect a med student to leave, but still ask to be invited to come back for the 'fun scut.'
So, I don't care if a student ghosts. It's his education, doesn't bother me
I don't care if a med student hovers; I'll teach. It does stink that there's no good place for them to sit, though. It's awkward for them, not me.
But, I do get mildly annoyed if a med student asks me to do more work for them. They could have stuck around; or they could have left and come back on time to the correct location with the info they had; or they could have left, period. But, dangnabbit, they asked for hand holding!

I do agree setting expectations is important. Just didn't think I'd have to formally state "Don't leave until the patient care is done." I don't know how to do it without sounding like a kindergarten cop...

 

[ThoracicGuy]

no there isn't...

Oh but there is this magical place called the operating room!

 

[TraumaLlamaMD]

Sounds like you should just tell them you're not going to be texting them and they should plan to meet back at the arranged time if they're not going to stay.

 

[jw3600]

Yep. Surgery can be fun....that day I also did two OR cases, a line, and some consults.


I don't think med student education should be entirely dependent on my constant interaction with them 100% of the time. I expect them to listen to a general conversation about patient care with the nurses on the ICU patients they're following, even if I am not talking to the med student directly.


I don't care if med students are there or not; if they are, I'll teach and if not I won't. I had clearly announced I would be doing certain tasks in certain rooms at a certain time. It shouldn't take a miracle for them to figure out where and when they should be there.

These are some M4s, not exactly brand new. As mentioned, I had announced what, where, and when - no mind reading required. Had they stuck around, they would have been ready. Or they could have left and come back on time without a problem. Instead, they left for the boring parts, but wanted me to invite them back for the fun stuff. I happen to think the notes/nurse interactions/etc. is educational for them; they apparently didn't.

These are M4s. They were on the rotation before I started, and I've worked with them for a total of 8 days. And we're talking about their ability to locate dressing supplies and start to take off an ABD and gauze, not perform an ex-lap.

That sounds infantalizing to med students. If a resident is not constantly teaching them or constantly paying attention to their precious selves, they have no choice but to disengage? I think adults should be able to go 20 minutes while listening to a general conversation about patient care without my having to directly spoon feed them. Or what, they'll revenge eval me? Hasn't happened yet, my evals are fine.


If there is nothing going on, I do dismiss them to home or study or wherever. But there were things going on, and they just left (which is fine) but then asked me to invite them back.


No, it's not annoying to have med students disappear. If they're present, fine; if not, they're paying a lot of money for whatever it is they're doing.

Surgery hours are longer for surgery residents.
These med students lead a cush surgery life - never in before 0530 and usually in at 0630, never home later than 1730. Today I sent them home at 2pm. On the day ERAS 'opened', I sent them home at 10am. They have had at least a 30minute sit-down lunch every day and have had at least one hour every day during the work day to themselves.

Stud.

Well, I'm trying....
I don't care if they're actually useful. Like 'Shem' says, if they'll only triple my work, I'll kiss their feet.


1-4. I like the shadow idea; have used it a few times. In this particular case, though, they all skeedaddled.

To clarify: Team rounds finishing up, I announce I am going to do xyz in rooms a,b,c in about 20 minutes. Formal rounds end (the attending leaves), med student says 'Will you text us before you start?'. I'm a bit nonplussed because there is still a group of people around, med students mixed in, and I've already said when I'll start. It's open concept area, I'm at a computer and going to discuss patient care with the nurses while referencing the EMR/doing orders/updating notes (surgery notes, not the medicine novel ones); these are patients the students are following and it's a general conversation. I look around, and then the med students are gone. Hadn't had a chance to formally dismiss them (which I wasn't going to do immediately, since there were procedures and things to do still and I thought the convo useful to them); hadn't had a chance to review their notes individually with them - which I had done on previous days. It was just not a juncture at which I would expect a med student to leave, but still ask to be invited to come back for the 'fun scut.'
So, I don't care if a student ghosts. It's his education, doesn't bother me
I don't care if a med student hovers; I'll teach. It does stink that there's no good place for them to sit, though. It's awkward for them, not me.
But, I do get mildly annoyed if a med student asks me to do more work for them. They could have stuck around; or they could have left and come back on time to the correct location with the info they had; or they could have left, period. But, dangnabbit, they asked for hand holding!

I do agree setting expectations is important. Just didn't think I'd have to formally state "Don't leave until the patient care is done." I don't know how to do it without sounding like a kindergarten cop...

Sounds like you might just have some lazy med students.

But to be clear (and I read the majority of your novelish posts) it does sound like you don't want them hovering but also want them there immediately for things. This can be easily solved by just texting them when you're going to do something. But now you're complaining about having to text them. It just seems like no solution is good enough for you.

 

[deleted480308]

"Hey med students, come over here for a minute. About the other day. Just need to clear up that I was a bit annoyed at being asked to text you for a procedure when I had told you when it was starting. Let me clear up some expectations. If you don't care about this rotation and want to ghost after rounds, you'll get a mediocre eval but we'll be ok. If you want to be doing and seeing things it's your job to be around not my job to remind you. If that means you just show up early for stuff so you don't miss it...fine. If the group wants to leave one person as a lookout to text the others.....fine. I'm fine with you hovering if you can just have some ability to read the room about when to be quiet"

 

[deleted480308]

And by the way OP, your schedule for students is definitely sweet. I had a much harder surgery month

 

[MackandBlues]

Sounds like lazy med students. You told them when, where, and what and they didn't show? Not cool. Also looks like you'll need to tell them they cannot go to their study area until you allow them to if you want them to observe the workflow.


Sent from my iPhone using SDN mobile

 

[Crayola227]

I remember as a med student being on rotations where the "resident room" was a closet that fit 4 people
there were times I swear to ****ing God I sat crosslegged in the hallway outside that door waiting for hours, and PocketMed or some other pocket resource was my only friend

honestly, it sounds like there are some mixed messages these students are getting
you have to make up your mind what you want from them and tell them, firmly
if you send your students away, then it is your responsibility to give them a firm time/place that you commit to, to have them meet you back, or for you to text them

if you don't want to do that, then tell them they need to be your shadow and follow you into the toilet (basically my med school experience)
if you do that, the kind thing is to allow them to read things

I'm not sure they're lazy, they may be finding it difficult to know what the expectations are and what is educational

I'll be honest, as a med student, I didn't always know what I was supposed to be learning from some conversations I watched docs have with each other and other nurses, I don't learn that way, I didn't get that stuff until I was in the pilot seat or I was told explicitly

if you want them present while you talk to nurses about UOP, answer pages, then do your very best after each of these interactions to "clue them in" - even just 1 sentence

I don't know how it is in surgery, but I always made a point at the end of the day to talk about that kind of stuff with students
I didn't just say, "any questions?" because they don't always know what to ask
they've never been in my shoes, I've been in theirs, it's a bit easier for me to think back on the day and explain stuff, not like "here's how we work up hyponatremia" but also stuff like "that nurse and I got into a disagreement about using haldol in this patient because...."

 

[WhiteCoatWonder]

From the student perspective, I'd think it would be better to just follow you and learn how to not get in the way (and other "soft skills"). Asking a busy person for the opportunity to possibly annoy them (and feed into the "weak, entitled Millenials" stereotype) is strange.

I expect to use/develop my situation-awareness and stealth when I start rotations this summer. I can totally see some of my younger classmates hoping to get texts on rotations though...

i think thats the ticket. just stayed a non-hovering 3 breadths away, doing something academic (as there is always something to study, even while holding up the wall, out of the way). once i saw my residents walking fast, i was afoot.

 

[iBS1972]

M4: If they're just starting out their rotations as a M3, I can understand that behavior. Otherwise, I think it's a sign that they're not very interested in the rotation and/or they're okay with getting a HP instead of H. There's always stuff you can do and read. I've learned to take advantage of as much opportunities to learn as I can. I realize that's it's better to learn about things now than later. For example, I was on pain management elective (2wks)--we don't have an exam for electives, but I wanted to learn as much as I could so I bought Secrets to Pain Management; same thing when I was on Palliative Care--I would youtube things when I get home; I will continue doing this on my GI pulm renal rotations--I will get the corresponding Secrets book and read them during those elective rotations even if we will not be tested. It sounds like this is a surgical rotation, and I know for darn sure there's a shelf exam for that, so they can stand around and do questions or read Pestana--they don't have to stand and just stare blankly into space. Perhaps the most useful thing though is talk to patients and learn more about their past medical history and their symptomology, even if you've already finished rounding. There's ALWAYS things that can be done--it's just a matter of will power/interest, if you're not interested, you're not going to think about it. Again, if they're just starting out their rotations, I guess it's okay.

 

[evilbooyaa]

Just tell them (as the resident) that their (the students) behavior is unacceptable and if they are not on time or early for the planned events there will not be texts going out to remind them.

"If I say meet at room 702 at 11am, do not expect a text, just be there."

Personally, I'd rather have the students hovering around me reading than off in la-la land somewhere else, but if your personality is that you can't get **** done while having people breathing over your shoulder, then at least be firm about your expectations with them, OP.

Although re-reading your OP, it doesn't sound overtly sound like you're against the idea of them hanging around the unit being ready to go. I would do that.

 

[DoctwoB]

I don’t buy in to that you have to set expectations about every little thing for students. It’s an apprenticeship model. If there is something specific I want a student to do (e.g get numbers, pull drains, make the list, etc) I’ll tell them. I will tell them it’s helpful to make a dressing bucket and carry it on rounds and they’re expected to know everything and anything about the patients they’ve been in OR cases for. If we all have downtime I’ll do some teaching. If I’m charting or doing something they can’t benefit from then they can take some freaking initiative. Read. Talk to the patients you’re following. Follow up on scans, Is/Os, I don’t care. But it’s not an excuse to peace out. I’m a nice guy, I won’t keep you here for the hell of it if there is nothing going on.